BENJAMIN MICHAEL COPLAN, D.O.
NPI 1033324181, individual, Greenwood, IN, Psychiatry & Neurology, Child & Adolescent Psychiatry
- Hours beyond a day in 1 month, but with up to 700 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| May 2018 | More hours than a day holds, even counting one unit per claim line | 26.4 | 21.8 | 14.5 | 19.6 | 586 | 2 | 90791 90792 90834 90847 99213 99214 | $43K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | BENJAMIN MICHAEL COPLAN, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | May 11, 2007, last updated November 27, 2023 |
| Practice location | 3000 S STATE ROAD 135, STE 230, Greenwood, IN 46143-9607, 317-535-0728 |
| Mailing address | 6626 E 75TH STREET, STE 500, Indianapolis, IN 46250-2890 |
| Specialties | Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, primary, license 02004184A IN) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, license 036122961 IL) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | $1.5M | 49% | $127 | $101 (top 5% from $318) | 63rd percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $696K | 23% | $103 | $60 (top 5% from $133) | 87th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $218K | 7% | $72 | $44 (top 5% from $110) | 83rd percentile | |
| 90832 | Psychotherapy, 30 minutes | $197K | 7% | $104 | $59 (top 5% from $239) | 82nd percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $92K | 3% | $73 | $130 (top 5% from $458) | 14th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $60K | 2% | $79 | $105 (top 5% from $228) | 30th percentile | |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | $57K | 2% | $95 | $16 (top 5% from $128) | 91st percentile | |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | $50K | 2% | $48 | $37 (top 5% from $103) | 65th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 37 | 19 | $1K | $59 | $46 | 1.3x | 2.4x (90th percentile 4.0x) |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 12 | 12 | $870 | $208 | $111 | 1.9x | 2.7x (90th percentile 4.4x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
5 providers in Johnson County, IN carry an indicator in the public record, with $6.5M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | INDIANA MASONIC HOME, INC. Franklin, IN, ranked 3015 | $0 |
|
| 3 | JOHNSON MEMORIAL HOSPITAL Franklin, IN, ranked 5513 | $0 |
|
| 4 | EMILY ZARSE Greenwood, IN, ranked 8491 | $3.6M |
|
| 5 | JENNIFER COMER Greenwood, IN, ranked 9955 | $2.2M |
|
| 5 | THOMAS SMALL Franklin, IN, ranked 11153 | $657K |
Recent enforcement in IN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.